| NPI | 1871344226 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN MICHALE TYSON Director 203-908-8978 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2024-04-01 |
| Last Update Date | 2024-04-01 |